Reinehr Thomas, Andler Werner, Denzer Christian, Siegried Wolfgang, Mayer H, Wabitsch Martin
Department of Pediatrics, University of Witten-Herdecke, Dr. F. Steiner Str. 5, 45711 Datteln, Germany.
Nutr Metab Cardiovasc Dis. 2005 Jun;15(3):181-7. doi: 10.1016/j.numecd.2004.06.003.
So far in Europe, no large studies have been published on the frequencies of the cardiovascular risk factors hypertension and dyslipidaemia in overweight children.
Diagnosis of hypertension, decreased HDL-cholesterol, increased triglycerides, total and LDL-cholesterol were documented for 1004 overweight children and adolescents (aged 4-8 years, 52% girls, BMI-SDS in median 2.43) referred to four obesity centres. Hypertension and dyslipidaemia were defined by cut off points above the 95th percentile of healthy children. Multivariate linear regression was conducted for the dependent variables systolic and diastolic blood pressure, triglycerides, HDL-, LDL-, and total cholesterol, including gender, degree of overweight (SDS-BMI) and age as independent variables.
Thirty-seven percent of the children studied suffered from hypertension, 27% displayed increased total cholesterol, 26% increased LDL-cholesterol, 20% increased triglycerides and 18% decreased HDL-cholesterol. Seventy percent of all children had at least one unfavourable cardiovascular risk factor. Hypertension and dyslipidaemia were observed in any age group and in any degree of overweight at least twofold above the suspected rate of 5%. SDS-BMI was significantly related to blood pressure (systolic: coefficient 7.26, p < 0.001, diastolic: coefficient 3.21, p < 0.001), weakly to triglycerides (coefficient 0.12, p = 0.007), slightly negatively to HDL-cholesterol (coefficient -0.06, p = 0.001) and not related to total and LDL-cholesterol. Age was positively related to blood pressure (systolic: coefficient 2.436, p < 0.001, diastolic: coefficient 0.54, p < 0.001) and negatively to HDL cholesterol (coefficient -0.02, p < 0.001).
Cardiovascular risk factors were frequently present in a large collective of overweight European children and adolescents. They occurred mostly independently of age, gender and degree of overweight. Therefore, screening for cardiovascular risk factors seems meaningful at any age and degree of overweight in childhood.
到目前为止，在欧洲尚未发表关于超重儿童心血管危险因素高血压和血脂异常发生率的大型研究。
记录了转诊至四个肥胖中心的1004名超重儿童和青少年（4至8岁，52%为女孩，BMI-SDS中位数为2.43）的高血压、高密度脂蛋白胆固醇降低、甘油三酯升高、总胆固醇和低密度脂蛋白胆固醇情况。高血压和血脂异常通过高于健康儿童第95百分位数的切点来定义。以收缩压和舒张压、甘油三酯、高密度脂蛋白、低密度脂蛋白和总胆固醇作为因变量，进行多变量线性回归分析，自变量包括性别、超重程度（SDS-BMI）和年龄。
37%的研究儿童患有高血压，27%的总胆固醇升高，26%的低密度脂蛋白胆固醇升高，20%的甘油三酯升高，18%的高密度脂蛋白胆固醇降低。70%的儿童至少有一种不利的心血管危险因素。在任何年龄组和任何超重程度中，高血压和血脂异常的发生率至少是可疑率5%的两倍。SDS-BMI与血压显著相关（收缩压：系数7.26，p<0.001；舒张压：系数3.21，p<0.001），与甘油三酯弱相关（系数0.12，p = 0.007），与高密度脂蛋白胆固醇呈轻微负相关（系数-0.06，p = 0.001），与总胆固醇和低密度脂蛋白胆固醇无关。年龄与血压呈正相关（收缩压：系数2.436，p<0.001；舒张压：系数0.54，p<0.001），与高密度脂蛋白胆固醇呈负相关（系数-0.02，p<0.001）。
在大量欧洲超重儿童和青少年群体中，心血管危险因素经常存在。它们大多独立于年龄、性别和超重程度出现。因此，在儿童期的任何年龄和超重程度下筛查心血管危险因素似乎都有意义。
